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TherapistJen, LCSW, CPC

Category: Mental Health

Satisfied Customers: 3436

Experience: Licensed Clinical Social Worker.

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I've been in psychoanalytical therapy for the last 2 years

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Hi,I've been in psychoanalytical therapy for the last 2 years and am now in a situation where I can no longer afford to continue on an ongoing weekly basis due to financial restrictions. My therapist offered to help out (due to ethical considerations) and wants me to negotiate her fees.My problem is this; As much as I really need to continue with therapy (probably 2-3 times per week), she has asked me to come up with what I think is a reasonable fee...she wants me to negotiate and she is aware that I have issues with that.I'm stuck between a rock and a hard place. Yes, I need to continue, but I can't for the life of me accept that she would lower her fees for me. I also realize I'm probably not the first patient she has done this with.I've had time to think and am willing to negotiate but I'm not sure how to approach the subject as I'm really not sure what would be acceptable.Any suggestions?Thanks!Theresa

Hi. Welcome. I am a Licensed Master Social Worker with more than 20 years experience working with individuals and families on a variety of issues.

CoachJenK :

Hi Theresa, what is the most difficult part for you? That she would offer this gift to you or coming up with a reasonable number to put forth?

Customer:

I am the type of person who's always done everything on her own. I'll give the shirt off my back to anyone who needs help, but have a difficult time accepting help from anyone else...it's almost impossible for me to do so without feeling obligated to give something back. Also, yes, a reasonable fee is an issue...

CoachJenK :

Your work with her is important and she can see the positive results and would like that to continue.

CoachJenK :

As therapists we often have room in our work to reduce fees when it comes up.

CoachJenK :

I hear you perfectly and I think she does as well...which is why she is giving you this "work" as it will be another step in your growth.

CoachJenK :

but your work is to allow it to happen but also deal with the feelings that are coming up around it.

Customer:

yes, and she knows how important it would be for me to follow through with the present issues

CoachJenK :

exactly

CoachJenK :

but your feelings that are coming up around this must also be processed with her as this is most likely true of how you feel in the world with others giving and you being able to accept.

CoachJenK :

this will be a great space of growth for you as you work through this with her.

Customer:

But, this issue, having difficulty negotiating, is something we've never discussed...it's a whole new ballgame. I need to come up with this 'negotiating' for tonight's session...

CoachJenK :

Clearly you have already done a great amount of work with her and have wonderful insight....this is just another step along the way.

CoachJenK :

and she is right on by having you come up with it as she knows that if she just throws out a number that possibly pre-empts your ability and growth in this area.

CoachJenK :

so to be concrete about it....you look at your finances, what you pay her now and what umber would be doable for you to remain in treatment with her. Then it is up to her to see if that works on her end. Your responsibility is only your end and she will be able to take care of herself and let you know what is reasonable for her.

Customer:

Crap...I guess I'm overwhelmed with all this 'growth'. It feels more like a confrontation for me...I'm afraid I'll feel uncomfortable during my 'discounted' sessions

CoachJenK :

I am smiling cause I think you can do this...I hear the struggle but you have already had so much growth with her. And your feelings of discomfort must also be addressed with her...this is real life and if you feel these things with her then you also feel these things with others.

CoachJenK :

growth is tough but from what I hear you are doing great. Way better than crap. :-)

Customer:

it's been mind boggling!

I've always 're-paid' whatever help I've received from anyone with something personal, sort of like a gift of sorts. Is it unethical to offer her some sort of service in exchange for therapy?

CoachJenK :

It is not uncommon for someone in therapy to want to give back in that way...not just because of fees being lowered but also because of feeling wonderful about the growth. I think the expression of that desire and seeing the growth is the biggest gift we, as therapists can get from our clients.

CoachJenK :

She is enrisched by your work together and that is a great gift.

CoachJenK :

*enriched

Customer:

Ah, but I must not feel like I 'owe' her anything in the end...

I am a certified massage therapist and a bookkeepper...I know she needs help with her billing practice and a massage is always welcome...I'm not comfortable offering this as an exchange as she may think I'm 'overstepping' the boundaries...which I have no intent on doing.

She's very professional and I wouldn't want to jeopardize this professionalism but it's really something I think would be beneficial...

CoachJenK :

I hear a wonderful professional in her and I do not believe she will accept those offers but rather focus on the desire you feel to give back. We get our gifts in seeing growth and happiness. That is fulfilling beyond anything.

CoachJenK :

Talking to her about all of these feelings will help you work it through with her and you can express the gratitude you feel. She would not lower her fees if she couldnt and certainly would not lower them with the expectation of something in return.

CoachJenK :

thoughts?

Customer:

coming up...

Customer:

I hear you...thanks for the reassurance. I'll have to deal with 'accepting' something from someone else for a change...won't be easy. She's aware of the difficulty I have with this issue and thinks 'that's something else we can work on' but then if I do that, seems like we'll never finish this therapy!

CoachJenK :

You are doing so well and this isnt another issue....it is all part of you and working on it helps you in your other relationships as well. being a giver is a beautiful trait but accepting is too...you can get there and as we say in our business "the work is in the room." so if this is coming up in there then it is something where you can have further understanding.

CoachJenK :

Are you still with me?

CoachJenK :

I think you went offline. Please take a moment to click on the rating tab to offer a rating of my work. my goal is EXCELLENT. It is the only way I am credited for my time. Thanks so much.

Customer:

ooopps....not what i wanted to rate you...can I change the rating?

CoachJenK :

phew. :-)

CoachJenK :

I was like did i really give you poor service?

Customer:

sorry,,,,just came back from lunch and was distracted...I want to change my rating to excellent...can we change it?

Customer:

no no...sorry

CoachJenK :

you can click on the rating tab again and offer a rating of excellent and it will cancel that poor rating out.

Customer:

there were a lot of people around me and I touchg the wrong button

CoachJenK :

its okay. you can change it by doing it again.

Customer:

got it...

Any chance I can speak with you again tomorrow? (after my attempted negotiations?)

CoachJenK :

Keep your mind open tonight and let all of your feelings come up and discuss them all.

CoachJenK :

yes you can always come back by submitting a new question and putting for CoachJenK at teh beginning and it will come to me.

Customer:

great! Thank you and have a nice day!

CoachJenK :

my pleasure. Wishing you well tonight and thank you for taking a moment now to correct the rating.

TherapistJen and other Mental Health Specialists are ready to help you

Start a new question like you did yesterday and at the beginning of your question put for CoachJenK only. FYI. In 5 minutes I need to step away just for about 5 minutes. I will let you know in chat when that is.